Articles and Resources

QUOTE: The British drug maker GlaxoSmithKline will no longer pay doctors to promote its products and will stop tying compensation of sales representatives to the number of prescriptions doctors write, its chief executive said Monday, effectively ending two common industry practices that critics have long assailed as troublesome conflicts of interest.

QUOTE: A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries...Rising costs of drugs, medical equipment and other services, and fees from layers of middlemen, play a significant role in escalating hospital bills, of course. But just as important is that mergers and consolidation have resulted in a couple of hospital chains — like Partners in Boston, or Banner in Phoenix — dominating many parts of the country...

QUOTE: Andrea Sloan is dying of ovarian cancer. Having exhausted all standard treatment options, her doctors say her best hope now is a new class of cancer drugs called PARP inhibitors....But she's not getting the treatment because the company is refusing to give it to her. That's because this drug she wants is still in clinical trials, and the company says hasn't been proven effective.

QUOTE: a lack of standardization in COI disclosures increases the administrative burden on physicians and increases the chances of being accused of incomplete and misleading statements. As a solution, their committee — facilitated by the Institute of Medicine — recommends the creation of a centralize database for the disclosure and reporting of interests.

QUOTE: Their joint crusade, stated repeatedly in editorials for the journal and since expanded in books and dozens of articles in the lay press, is against for-profit medicine, especially its ancillary profit centers of commercial insurance and drug manufacture — in Dr. Relman’s words, “the people who are making a zillion bucks out of the commercial exploitation of medicine.”

QUOTE: RateMDs now has reviews of more than 1,370,000 doctors in the United States and Canada. But getting in the faces of the previously untouchable professional class has inevitably led to legal threats. He says he gets about one each week over negative reviews and receives subpoenas every month or two for information that can help identify reviewers, who believe they are posting anonymously.

QUOTE: Changing course after an unwelcome national uproar, the Virginia Senate adopted a revised bill on Tuesday that still requires doctors to perform an ultrasound on women before they have an abortion, but also says that women cannot be forced to have an invasive vaginal ultrasound....The Senate vote came after a bitter debate in which Democrats pleaded with the body not to adopt a bill that they said remained — even with the changes — demeaning to women and insulting to doctors.

QUOTE: although two-thirds of doctors agree they should share serious medical errors with their patients, one-third did not completely agree. Nearly two-fifths of the respondents said they did not disclose their financial relationships with drug and device companies. And more than 55% of physicians said they often or sometimes described a patient's prognosis in a more positive manner than the facts might support.

QUOTE: A patient has filed a class-action lawsuit against his New York dentist over her attempts to use copyright law to gag the patient's online reviews of her services. Robert Lee, who recently moved to Maryland, has asked a New York federal court to declare that his comments are protected under copyright's fair use doctrine, that the dentist's attempts to gag him breach dental ethics, and that the "privacy agreement" the patient was forced to sign is invalid and illegal under New York law.

QUOTE: growing problems in sports medicine, a medical subspecialty that has been experiencing explosive growth. Part of the field’s popularity, among patients and doctors alike, stems from the fact that celebrity athletes, desperate to get back to playing after an injury, have been trying unproven treatments, giving the procedures a sort of star appeal. But now researchers are questioning many of the procedures, including new ones that often have no rigorous studies to back them up.

QUOTE: Prodded by grieving parents, Spanish judges are investigating hundreds of charges that infants were abducted and sold for adoption over a 40-year period. What may have begun as political retaliation for leftist families during the dictatorship of Gen. Francisco Franco appears to have mutated into a trafficking business in which doctors, nurses and even nuns colluded with criminal networks.

QUOTE: Bombarded with pharmaceutical ads listing what seems like every conceivable side effect, American consumers might think they are already getting too much information. But they — and their doctors — are not getting what arguably matters most: independent, plain-English facts about the medication. Fortunately, there is a simple model for getting such information across.

QUOTE: In years gone by, doctors would likely have scoffed at the suggestion they reimburse patients for time spent waiting. But Farstad's doctor sent her a check for $100, the full amount she requested, and some tardy doctors tell CNN they give patients money (or a gift) before the patient even asks.

QUOTE: Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of “mystery shoppers” to pose as patients, call doctors’ offices and request appointments to see how difficult it is for people to get care when they need it....In response to the drumbeat of criticism, a federal health official said doctors need not worry because the data would be kept confidential.

QUOTE: Prosecutors alleged Monday that automatic weapons and ammunition were discovered in the hospital, that the defendants "hijacked" the hospital building and controlled it...Activists and human rights groups allege that the medical workers are being prosecuted for treating protesters.

QUOTE: an implant industry where producers seek to influence the brand of device that patients receive long before a diagnosis....big makers of implants like heart devices and artificial joints, including Johnson & Johnson, Boston Scientific and St. Jude Medical, have settled Justice Department charges that they illegally promoted sales. The enforcement effort has sought to reduce the role of corporate influence over medicine through tactics like bogus or inflated consulting deals with doctors.

QUOTE: there has been no easy way for consumers to shop for the best deal on a colonoscopy or blood test. A start-up financed by prominent venture capitalists and the Cleveland Clinic, Castlight Health, aims to change that by building a search engine for health care prices.

QUOTE: As large as the penalties are for drug companies caught breaking the off-label law, the fines are tiny compared with the firms' annual revenue. The $2.3 billion in fines and penalties Pfizer paid for marketing Bextra and three other drugs cited in the Sept. 2 plea agreement for off-label uses amount to just 14 percent of its $16.8 billion in revenue from selling those medicines from 2001 to 2008.

QUOTE: here's the dilemma: On one hand, doctors believe—despite some evidence to the contrary—that there are too many frivolous lawsuits, and they respond by ordering a lot of unnecessary testing and treatment... On the other hand, patients often get harmed by negligent medical care, and lawsuits are their only way to fight back.

QUOTE: Doctors and patients alike are accustomed to the firmly entrenched Doctor Knows Best status quo. But it is only by empowering patients... that health care can be made significantly more efficient and effective.

QUOTE: [medical] Residents who suffered from burnout and depression could pose as much risk to patients as those doctors-in-training who were exhausted, regardless and independent of their level of fatigue.

QUOTE: Over the last 30 years, despite countless efforts at change, poor hand hygiene has continued to contribute to the high rates of infections acquired in hospitals, clinics and other health care settings.

QUOTE: 2013. That’s the year everyone would have to have health insurance under the House version of the health care bill. ...many experts say it’s not nearly enough time to beef up the supply of physicians necessary to care for the tens of millions suddenly entering the health care system.

QUOTE: Physicians who are signing out may inadvertently omit information, such as the rationale for a certain antibiotic or a key piece of the patient’s surgical history. And doctors who are receiving the information may not assume the same level of responsibility for the care of that patient.

QUOTE: Combining education with entertainment and patient care with promotion, live telesurgery is a fixture at surgical conferences and marketing campaigns by hospitals and medical device manufacturers

QUOTE: A host of studies and reports by academics and the federal government shows that physicians who own scanners order many more scans than those who do not. As a result, Americans pay billions of dollars in extra taxes and insurance premiums.

QUOTE: Does my child really need drugs for ADHD, and if so, is there a point when he or she should stop taking them?...Because drug companies tend to give samples for only the most expensive drugs, once the samples run out, you'll end up paying more than if your child had been prescribed a generic drug.

QUOTE: One of the largest sources of campaign contributions to Senate Democrats during this year’s health care debate is a physician-owned hospital [Doctors Hospital at Renaissance] in one of the country’s poorest regions that has sought to soften measures that could choke its rapid growth.

QUOTE: The human rights group [Amnesty International] argues that banning so-called therapeutic abortions - undertaken in order to preserve the health of the mother - not only endangers lives but also puts medical professionals in an "unconscionable" position.

QUOTE: While it's extremely difficult to tell in any given situation how much race -- consciously or subconsciously -- plays a role in a doctor's decision making, multiple studies over several decades have found doctors make different decisions for black patients and white patients even when they have the same medical problems and the same insurance

QUOTE: Clinicians who are unaware of cultural influences may not only miss important medical implications for a patient but can also inadvertently exacerbate an often already tenuous therapeutic relationship.

QUOTE: The rising [medical] commercialism, driven in part by increasing expenses and decreasing reimbursement, has obvious consequences for the public: ballooning costs, fraying of the traditional doctor-patient relationship.

QUOTE: For patients with prostate cancer, it is a common surgical procedure: a doctor implants dozens of radioactive seeds to attack the disease. But when Dr. Gary D. Kao treated one patient at the veterans’ hospital in Philadelphia, his aim was more than a little off. Most of the seeds... landed in the patient’s healthy bladder... It was a serious mistake, and under federal rules, regulators investigated. But Dr. Kao, with their consent, made his mistake all but disappear.

QUOTE: Desperate to help their autistic children, hundreds of parents nationwide are turning to an unproven and potentially damaging treatment: multiple high doses of a drug sometimes used to chemically castrate sex offenders.

QUOTE: It's not the first time Winfrey's advice on health issues has raised concern. In the past, the media mogul has been criticized for promoting cosmetic therapies that were untested and later deemed dangerous.

QUOTE: Nine dissident scientists signed letters to President Obama and others in the administration charging that agency officials had acted illegally and that patients were routinely put at risk by medical devices approved for sale despite significant and often unanimous objections from scientific reviewers.

QUOTE: As increasing numbers of the unemployed and uninsured turn to the nation’s emergency rooms as a medical last resort, doctors warn that the centers — many already overburdened — could have even more trouble handling the heart attacks, broken bones and other traumas that define their core mission. Even before the recession became evident, many emergency rooms around the country were already overcrowded, with dangerously long waits for some patients...

QUOTE: The biggest change in the last 40 years, Mr. Callahan said to me, is that there are no limits. There's nothing we can't do for an old person, and there's a lot of pressure to do it. This is considered progress, and its considered ageism to be skeptical. But we can't go on this way. It's unaffordable. And it's the hardest dilemma in our society because theres no good way to deal with it other than saying no.

QUOTE: There is an ethical dilemma to consider about GH and the entire lifestyle drug market. Once a lifestyle drug is readily available and widely consumed, it can lead to a shift in what society considers normal. If height can be enhanced by "plastic endocrinologists" for the right price, we're redefining normal, and leaving those who can't afford these services behind.

QUOTE: "I tried being the 'good patient,' " said Mayer, who until illness forced her to retire was an assistant research professor in the school of public health at the University of North Carolina at Chapel Hill. Becoming difficult -- some, she said, might call it "empowered" -- was her "natural reaction" to doctors who were "incompetent, rude or domineering."

QUOTE: Off-label use accounts for somewhere between half and three-quarters of all medications used in children and is also commonly used for adult treatment. Pediatricians are often uncomfortable with this practice, but they consider it the lesser of two evils when confronting an illness with effective adult treatment but nothing for children. Most medications behave similarly in children and adults, but that rule has exceptions, as we sometimes discover too late.

QUOTE: It's not uncommon for patients with no insurance or poor insurance to receive different treatment. A 2006 study of 25 primary care private practices in the Washington area showed that in nearly one in four encounters, physicians reported adjusting their clinical management based on a patient's insurance status; nearly 90 percent of physicians admitted to making such adjustments.